Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 008226 | CT |
NPI | 1003189630 |
---|---|
Provider Name | Mrs. Deanna Santilli Mccaffrey |
First Address | Waterbury, CT 06702-2310 |
Second Address | Naugatuck, CT 06770-2310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2012 |
Last Update Date | 06/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008050268 | (05) | CT |
12793884 | CAQH (01) | |
5990834 | AETNA BEHAVIORAL HEALTH (01) | |
PENDING | CIGNA BEHAVIORAL HEALTH (01) | CT |